Payment Form

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AFP of Western PA accepts Visa, Mastercard, Discover and American Express

Please confirm the information below and select the number of people you will be paying for today. The "Event Name" and "Cost per attendee" should be pre-filled based on the event you would like to attend. If this information is incorrect use your browser's "Back" button or click here to return to the previous page.

Reason for payment

This field is automatically populated and should not be edited directly.

Cost $

This field is locked and should not be edited directly.

Number of Tickets or Packages *

How many will you be paying for today?

Total to be charged today $

This field is calculated automatically and should not be edited directly.

Title

Title Other...

First Name *

Last Name *

Suffix

Suffix Other...

Email Address *

Phone *

Extension

Organization

Please type the names of all attendees, or include additional notes for your payment

Special Diet Needs

Please indicate any special dietary needs

The following information must match the billing address of the credit card you will be using to pay.